Skip to Main Content
Home Books Medication Therapy Management: A Comprehensive Approach, 2e

Chapter 20: Depression MTM Data Set

Stacey D. Curtis; Kristin W. Weitzel

KEY POINTS

KEY POINTS

Depression is a common and chronic disease that can cause serious harm to patients and increases the risk of death.

  • Treatment goals for depression include reduction or remission of current symptoms, return to a full level of functioning, and prevention of future depressive episodes and/or relapse.

  • Medications commonly used to treat depression include selective serotonin reuptake inhibitors (eg, sertraline), serotonin-norepinephrine reuptake inhibitors (eg, venlafaxine), bupropion, and tricyclic antidepressants (eg, amitriptyline).

  • MTM providers should educate patients and/or their support system (eg, family members) about the delay in onset of antidepressant effects.

  • Medication therapy management (MTM) providers should explain the importance of adherence throughout the entire course of antidepressant treatment.

  • MTM providers should advise care when patients are switching between antidepressants to avoid withdrawal symptoms and ensure a consistent therapeutic response.

  • Patients with depression should be assessed for suicide risk, and MTM providers should be familiar with supportive resources for patients expressing suicidal ideation (eg, National Suicide Prevention Lifeline 1-800-273-8255).

INTRODUCTION TO MAJOR DEPRESSIVE DISORDER

Recognizing Depression

Major depressive disorder (MDD) is characterized by discrete episodes of at least 2 weeks’ duration (although most episodes last considerably longer) involving clear-cut changes in affect, cognition, and neurovegetative functions, and interepisode remissions.1 According to criteria listed in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, a major depressive episode is defined by the criteria listed in Table 20-1.1

TABLE 20-1DSM-5 Diagnostic Criteria for Major Depressive Disorder
View Table|Favorite Table|Download (.pdf)
TABLE 20-1 DSM-5 Diagnostic Criteria for Major Depressive Disorder

  1. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

    Note: Do not include symptoms that are clearly attributable to another medical condition.

    1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (eg, feels sad, empty, and hopeless) or observation made by others (eg, appears tearful). (Note: In children and adolescents, can be irritable mood.)

    2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).

    3. Significant weight loss when not dieting or weight gain (eg, a change of >5% of body weight in a month), or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain.)

    4. Insomnia or hypersomnia nearly every day.

    5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).

    6. Fatigue or loss of energy nearly every day.

    7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).

    8. Diminished ability to ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.

This site uses cookies to provide, maintain and improve your experience. MHE Privacy Center Close